Endothelial Progenitor Cells in Subclinical Hypothyroidism: The Effect of Thyroid Hormone Replacement Therapy

Shakoor, Shaikh Abdul Kader Kamaldeen Abdul; Aldibbiat, A; Ingoe, Lorna; Campbell, Susan L.; Sibal, Latika; Shaw, James; Home, Philip; Razvi, Salman; Weaver, Jolanta U.

doi:10.1210/jc.2009-1421

Cited by 34 publications

(27 citation statements)

References 19 publications

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“…18 A novel marker of CV risk, low circulating endothelial progenitor cells (EPC), has also been related to SCH independently of lipids and other variables (n = 20). 90 EPC number increased after levothyroxine treatment, whereas no significant amelioration of lipid profile (except for a small increase in HDL-C) was noticed.…”

mentioning

confidence: 75%

Subclinical hypothyroidism and vascular risk: Αn update

Lioudaki¹,

Mavroeidi²,

Mikhailidis³

et al. 2013

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subclinical hypothyroidism (scH), defined as elevated serum thyroid-stimulating hormone (tsH) in the presence of normal circulating free thyroxine (Ft4) and triiodothyronine (t3), is a relatively common condition. replacement treatment with levothyroxine is justified only for individuals with tsH levels >10 mIU/l. serum lipid levels are influenced by thyroid status and there is evidence pointing to a link between scH and an unfavorable lipid profile. Despite some conflicting data, most studies suggest that levothyroxine treatment may exert a beneficial effect on the lipid profile in scH regarding mainly total cholesterol and low-density lipoproteincholesterol. Moreover, it appears that treatment may also improve some other markers associated with cardiovascular (cV) disease such as carotid intima media thickness ( 17-03-201317-03- , Accepted 20-10-2013 Review (FT4) and triiodothyronine (T3) levels within the reference range.1 This is a relatively common condition with a prevalence ranging from 4 to 15% in the general population and up to 20% among females aged >60 years. [2][3][4][5]

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mentioning

confidence: 75%

Subclinical hypothyroidism and vascular risk: Αn update

Lioudaki¹,

Mavroeidi²,

Mikhailidis³

et al. 2013

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“…The senescent state and reduced vascularity of these ulcers, coupled with a hypothetical reduction in peripheral blood stem cell content in chronic SCI as seen in other chronic diseases such as depression, hypothyroidism and atherosclerotic disease, may contribute to further delays in ulcer healing despite growth factor stimulation. [21][22][23] However, both undermined ulcers demonstrated a reduction in volume and an increase in granulation tissue with vascularity to suggest that they might respond to surgical flap care with more favorable responses than prior to the PRP treatments.…”

Section: Discussionmentioning

confidence: 99%

A case report on the use of sustained release platelet-rich plasma for the treatment of chronic pressure ulcers

Sell

Ericksen

Reis

et al. 2011

The Journal of Spinal Cord Medicine

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Background/objectives: Chronic pressure ulcers affect patient health, emotional state, and quality of life, causing considerable morbidity and mortality in addition to contributing to significant health care costs from lengthy hospitalizations to advanced home care and surgical care costs. The conventional treatment of these wounds can be slow due to their chronic inflammatory state and the senescence of local reparative cells. Platelet-rich plasma (PRP) therapy has been growing as a viable treatment alternative for a number of clinical applications and has potential benefit for use in chronic wounds. The sustained release of large quantities of autologous growth factors, cytokines, and other mediators found in PRP plus the favorable mononuclear cell profile of PRP may help us to stimulate wound healing and resolve chronic inflammation. Methods: Three veterans with spinal cord injury (SCI), presenting with chronic stage IV pressure ulcers, were treated with a sustained release PRP therapy to stimulate wound healing. Results: PRP treatment consistently resulted in the formation of granulation tissue and improved vascularity for each of the three patients treated, while reducing the overall ulcer area and volume. Conclusion: The controlled release of growth factors from PRP demonstrated a positive stimulatory effect on the healing rate of chronic pressure ulcers in individuals with SCI.

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“…Vascular abnormalities, such as increased vascular resistance, arterial stiffness, endothelial dysfunction, and atherosclerosis, have been also described [70,83,89,90,91]. Several interventional studies, some of which were randomised and placebo-controlled, showed that restoration of euthyroidism by L -thyroxine replacement therapy is able to improve most CV structural and functional surrogate markers [29,83,85,86,89].…”

Section: Who To Treat/who To Observe: Younger Adults (<65-70 Years)mentioning

confidence: 99%

2013 ETA Guideline: Management of Subclinical Hypothyroidism

Pearce¹,

Brabant²,

Duntas³

et al. 2013

Eur Thyroid J

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664

613

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Subclinical hypothyroidism (SCH) should be considered in two categories according to the elevation in serum thyroid-stimulating hormone (TSH) level: mildly increased TSH levels (4.0-10.0 mU/l) and more severely increased TSH value (>10 mU/l). An initially raised serum TSH, with FT₄ within reference range, should be investigated with a repeat measurement of both serum TSH and FT₄, along with thyroid peroxidase antibodies, preferably after a 2- to 3-month interval. Even in the absence of symptoms, replacement therapy with L-thyroxine is recommended for younger patients (<65-70 years) with serum TSH >10 mU/l. In younger SCH patients (serum TSH <10 mU/l) with symptoms suggestive of hypothyroidism, a trial of L-thyroxine replacement therapy should be considered. For such patients who have been started on L-thyroxine for symptoms attributed to SCH, response to treatment should be reviewed 3 or 4 months after a serum TSH within reference range is reached. If there is no improvement in symptoms, L-thyroxine therapy should generally be stopped. Age-specific local reference ranges for serum TSH should be considered in order to establish a diagnosis of SCH in older people. The oldest old subjects (>80-85 years) with elevated serum TSH ≤10 mU/l should be carefully followed with a wait-and-see strategy, generally avoiding hormonal treatment. If the decision is to treat SCH, then oral L-thyroxine, administered daily, is the treatment of choice. The serum TSH should be re-checked 2 months after starting L-thyroxine therapy, and dosage adjustments made accordingly. The aim for most adults should be to reach a stable serum TSH in the lower half of the reference range (0.4-2.5 mU/l). Once patients with SCH are commenced on L-thyroxine treatment, then serum TSH should be monitored at least annually thereafter.

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Endothelial Progenitor Cells in Subclinical Hypothyroidism: The Effect of Thyroid Hormone Replacement Therapy

Abstract: SCH predicted lower EPC count, which improved with T(4) treatment, independent of other CV risk factors, providing additional evidence that T(4) replacement may improve CV risk in SCH.

Cited by 34 publications

References 19 publications

Subclinical hypothyroidism and vascular risk: Αn update

Subclinical hypothyroidism and vascular risk: Αn update

A case report on the use of sustained release platelet-rich plasma for the treatment of chronic pressure ulcers

2013 ETA Guideline: Management of Subclinical Hypothyroidism

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